191603749-12-14-2022-11-AS-MVAO-CMCT3G-20221222132220

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 191603749
Report Date: 12/14/2022
Date Signed: 12/14/2022 02:59:52 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754

This is an official report of an unannounced visit/investigation of a complaint received in our office on
11/03/2022 and conducted by Evaluator Troy Agard

PUBLIC

COMPLAINT CONTROL NUMBER: 11-AS-20221103105015

FACILITY NAME:	MANOR, THE		FACILITY NUMBER:	191603749
ADMINISTRATOR:	STEPHANIE BROWN		FACILITY TYPE:	735
ADDRESS:	1905/2019 PICO BOULEVARD		TELEPHONE:	(310) 450-1748
CITY:	SANTA MONICA	STATE: CA	ZIP CODE:	90405
CAPACITY:	151	CENSUS: 143	DATE:	12/14/2022
		UNANNOUNCED	TIME BEGAN:	08:15 AM
MET WITH:	Stephanie Brown		TIME COMPLETED:	03:00 PM

ALLEGATION(S):

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Facility staff are not serving adequate food to residents.
Facility staff talk to resident in inappropriate manner.

INVESTIGATION FINDINGS:

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On 12/14/2022, Licensing Program Analyst (LPA) Troy Agard conducted an initial complaint investigation to address the allegations listed above. LPA Agard met with Stephanie Brown, Administrator and explained the purpose of this visit is to gather information for the complaint and deliver findings.

The investigation consisted of the following: On 12/14/2022, LPA Agard conducted a tour of the facility grounds for the main building and Annex. The main building is a three-story building with 33 client apartments, each containing between 2 and 4 separate rooms and a bathroom. There is a courtyard with a fenced and locked pool, a staff break room, a kitchen, dining room and activity room. LPA Agard requested the following documents which were received at the time of the visit. 1) A copy of the staff roster, 2) a copy of the client roster. 3) meal menu. LPA conducted interviews and reviewed documentation.

On 12/14/2022 LPA delivered findings.
Cont on 9099C

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Ulysses Coronel
LICENSING EVALUATOR NAME: Troy Agard
LICENSING EVALUATOR SIGNATURE:	DATE: 12/14/2022

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/14/2022

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

Page: 1 of 3

Control Number 11-AS-20221103105015

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754

FACILITY NAME: MANOR, THE	FACILITY NUMBER: 191603749
	VISIT DATE: 12/14/2022

NARRATIVE

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The investigation revealed the following...regarding the allegation: Facility staff are not serving adequate food to residents. It’s being alleged there is a concern that the clients' meals are not nutritious, and the clients are not provided alternative options to the daily menu. LPA interviewed 11 clients out of 143. 5 out of 11 confirmed the allegation. C1 states, “I don’t really like the food here. Sometimes I eat with friends. Sometimes it’s good and sometimes it’s not. They don’t really have many alternative options.” C3 states, “I’ve been complaining that the food here sucks for years. What they feed us is what I call garbage and is not healthy. There are no alternative options. C4 states, “I don’t really enjoy the food here. We are not given any alternative options for food. I never say anything about it. I either eat it or I don’t.” C11 states, “on a scale from 1-10. I would give it a 1 or 2. I’m a former cook. A 1 or 2 because the flavor is not there and because the food is always cold.” The other 6 interviewees all stated that the food was either “good” or “prepared well.”

During interviews with staff, LPA interviewed 6 out of 30 staff in total. 0 out of 6 confirmed the allegation. S1 states, “the food is fine, before we used to have substitutes like, yogurt, bananas, and apples. For lunch they have the option of a sandwich. I don’t know what happens in the kitchen now.” S2 states, “I know some of the residents don’t like the food. Some complain and we reported it. They have alternatives but it varies.” S3 states, “yes, some complain the chicken taste rancid. They will only eat breakfast. I personally tasted the food and I refused to eat here.” S4 states, “sometimes it’s true. The options they have is not that good. If they don’t eat the food, they are offered yogurt or a sandwich.” S5 states, “I’ve gotten some complaints. I tried to make changes with the portions size because they said it wasn’t enough. We did get a microwave because some of the clients have been complaining that the food is cold. They do offer alternatives in case you don’t want the meal on the menu. We offer ham sandwiches, Tuna and PB&J.” S6 states, “no that is not true. We have added foods to the menu and clients have been happier.” During a record review, LPA reviewed the meal menu from August to current. LPA observed balance meal options with alternative items to choose from.

Regarding the allegation: Facility staff talk to resident in inappropriate manner. It’s being alleged a staff is rude and speaks to the clients inappropriately when inquiring about menu selection or options. 1 out of 11 confirmed the allegation. C11 states, “the person that runs the kitchen is incredibly rude. I wish they would replace them.” All other clients denied having any issues or being a witness to any mistreatment or inappropriate conversations with staff and clients.

cont on 9099C

SUPERVISORS NAME: Ulysses Coronel
LICENSING EVALUATOR NAME: Troy Agard
LICENSING EVALUATOR SIGNATURE:	DATE: 12/14/2022

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/14/2022

LIC9099 (FAS) - (06/04)

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Control Number 11-AS-20221103105015

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754

FACILITY NAME: MANOR, THE	FACILITY NUMBER: 191603749
	VISIT DATE: 12/14/2022

NARRATIVE

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During interviews with staff, 2 out of 6 confirmed the allegation. S1 states, “sometimes S6 is rude to clients and even me.” S2 states, “I’ve heard rumors.” S3 states, “there has been confrontation with S6 and the clients, but management is aware. I’ve never witnessed anything because we don’t run into each other.” S4 states, “yes, S6 is rude. I remember a specific experience with C9. That day they were very upset because they couldn’t get food. They didn’t have a mask on and S6 refused to give them food.

Based on LPA’s observation, and interviews conducted, the preponderance of evidence standard has not been met. Although the allegation(s) may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation(s) are unsubstantiated.

An exit interview was conducted, and a copy of this report was provided.

SUPERVISORS NAME: Ulysses Coronel
LICENSING EVALUATOR NAME: Troy Agard
LICENSING EVALUATOR SIGNATURE:	DATE: 12/14/2022

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/14/2022

LIC9099 (FAS) - (06/04)

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